Histomorphology and immunohistochemical patterns in degenerative disc disease and clinical-radiological correlations: a prospective study

摘要

Purpose Degenerative disc disease (DDD) is a common condition causing low-back pain, disability and, eventually, neurological symptoms. This investigation aimed to investigate intervertebral disc DDD-related changes, evaluating histomorphology and cytokines secretion, and their clinical-radiological correlations. Methods This is a monocentric prospective observational study. A cohort of patients who underwent microdiscectomy for DDD, from June 2018 to January 2019, were enrolled. Discs samples were examined for histomorphology, chondrons count, immunohistochemistry for Hif-1 alpha, Nf200 and Egr-1. Demographical and clinical data were also collected. Results Twenty patients were finally included. MRI evaluation showed a Modic I alteration in nine patients and a Modic II in 11. The disability grade was low-moderate (ODI score was 40%) in 12. The Modic I was associated with a low-moderate disability in two (22%) patients and to a high disability in seven (88%) (p 40% groups, there were a significative higher mean disability grade 48.4 (+/- 8.3)%, number of chondrons per section, cells per chondron, Nf200+ nerve fibers and Hif-1 alpha expression, compared with Modic II and ODI <= 40% groups, respectively. There were no differences in terms of Egr-1 expression. Conclusions The discs with Modic I MRI signal could represent potential targets for medical treatments, whereas Modic II seems to be a more likely point of no return in a degenerative process. Therefore, further investigations are to better investigate inflammatory pathways and degenerative mechanisms in DDD.